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RheumNow Podcast – Like Father, Like Daughter (10.29.2021)

Oct 29, 2021 1:35 am

Dr. Jack Cush reviews the news and journal articles from the past week and discusses parent-child rheumatologists pairs.

  1. Baricitinib long-term safety in #RA - 3770 pts (14744 PYs). Incid rates/100 pt-yrs: - Serious infx 2.6 - H. Zoster 3 - MACE 0.5 - In pts ≥50yr w/ ≥1 CV risk MACE = 0.77 for 1st 2 yrs, then 0.6 - Cancer SIR 1.07 w/ low SMR 0.74 - DVT/PE risk 0.5 & 0.4

  2. Israeli study of 1497 fully vaccinated health care workers finds 39 (2.4% Breakthrough COVID infections (Jan-May 2021), most cases were mild or asymptomatic, 19% w/ persistent Sxs (>6 ws); infected had lower neutralizing Abs.

  3. MMWR reports those who have recv COVID-19 vaccine have lower risk non–COVID-19 mortality (vs unvaccinated). Adjusted rel risk of non–COVID-19 death for Pfizer-vaccine (2 doses RR 0.34), Moderna (0.31), Janssen (0.54). NO INCR MORTAL RISK IN VACCINATED

  4. ACR publishes a "White paper on Antimalarial Cardiac Toxicity"- reviewing drug hx, indications, effects and rare risk of arrhythmias, conduction abnormalities, cardiomyopathy, QTc prolongation. torsade de pointes. No evidence for routine ECG monitoring

  5. Short (3 min) walks intstead of sitting benefits RA w/ anticytokine effect (TNF, IL1RA), improved glucose, c-peptide, insulin. Crossover study 15 RA women who had 1) prolonged sitting, 2) 30-min mod-vigor exercise or 3) 3-min of light walking every 30 min

  6. 83 patients w/ ANCA Assoc. Vasculitis, hospital admitted, 44 died in-ICU (53%) w/ death by infection (61%), active vasculitis (34%). Predictors of ICU death were APACHE II score (OR=1.3) and respiratory failure (OR=620).

  7. Rheumatic pts admitted to ICU, #SLE is most common & Sepsis most common reason. 80 ARD pts adm to ICU: Dx were SLE (42%), RA (26%), vasculitis (12%) FOR Sepsis (31%), (10%) CHF (10%). 20% died in ICU, 5% 30d after ICU, 7.5% w/in 1 yr

  8. Among 825,556 sepsis pts in Taiwan (2003–2017), having SLE increased mortality risk 3 fold (HR 2.8;2.5–3.2), w/ adjustments (HR 1.47). Other risk mortality factors: age (1.02), prednisolone > 5mg/d (1.55), MTX (2.19) & immunosuppressives (1.45)

  9. BEAT-LUPUS: Sequential Belimumab After Rituximab in SLE

  10. Platelet-Rich Plasma Injections Fail in Ankle Osteoarthritis 

  11. Pfizer/Lilly Pull Tanezumab Development 

  12. Like Father Like Daughter

The author has received compensation as an advisor or consultant on this subject

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